1. INTRODUCTION
1.1. Aim and objectives
Lower urinary tract symptoms (LUTS) are a common complaint in adult men with a major impact on quality of life (QoL) and have a substantial economic burden. The present Guidelines focuses on offering practical evidence-based guidance on the assessment and treatment of men with various non-neurogenic benign forms of LUTS. The understanding of the lower urinary tract (LUT) as a functional unit, and the multifactorial aetiology of associated symptoms, means that LUTS now constitute the main focus, rather than the former emphasis on Benign Prostatic Hyperplasia (BPH). The term BPH is now regarded as inappropriate as it is Benign Prostatic Obstruction (BPO) that is treated if the obstruction is a significant cause of a man’s LUTS. It must be emphasised that clinical guidelines present the best evidence available to the experts. However, following guideline recommendations will not necessarily result in the best outcome. Guidelines can never replace clinical expertise when making treatment decisions for individual patients, but rather help to focus decisions - also taking personal values and preferences/individual circumstances of patients into account. Guidelines are not mandates and do not purport to be a legal standard of care.
1.2. Panel composition
The EAU Non-neurogenic Male LUTS Guidelines Panel consists of an international group of experts with urological and clinical epidemiological backgrounds. All experts involved in the production of this document have submitted potential conflict of interest statements which can be viewed on the EAU website Uroweb: https://uroweb.org/guidelines/management-of-non-neurogenic-male-luts/panel.
1.3. Available publications
A quick reference document, the Pocket Guidelines, is available in print and on the Uroweb website. These are abridged versions, which may require consultation together with the full text version. All documents are accessible through the EAU website Uroweb: http://www.uroweb.org/guideline/treatment-of-non-neurogenic-male-luts/.
1.4. Publication history
1.4.1. Publication history
The Non-neurogenic Male LUTS Guidelines was first published in 2000. Standard procedure for EAU Guidelines includes an annual assessment of newly published literature in the field to guide future updates.
1.4.2. Summary of changes
All chapters of the 2024 Male LUTS Guidelines have been updated, based on the 2022 version of the Guidelines. References have been added throughout the document. Other key changes incorporated in this publication includes:
- A new section 4.2.4 on Symptoms of Lower Urinary Tract Dysfunction Research Network;
- An update in section 4.8 on bladder voiding efficiency;
- A new section 5.2.7.4 regarding α1-blockers + Phosphodiesterase 5 inhibitors including a summary of evidence and recommendations;
- New recommendation in section 5.3.1.1 on open prostatectomy;
- New section in 5.6.2.1 on urodynamic testing for the management of male urinary incontinence;
- A new algorithm for men presenting with urinary incontinence;
- Two new summary of evidence statements in section 5.6.5.3;
- New subchapter on the management of underactive bladder, section 5.7.